Yao CaoYuan, Liu XiaoLi, Tang Ze
Department of Respiratory Medicine, Yongchuan Hospital, Chongqing Medical University.
Diabetes Department, Yongchuan Traditional Chinese Medical Hospital.
Int J Chron Obstruct Pulmon Dis. 2017 Aug 3;12:2285-2290. doi: 10.2147/COPD.S141760. eCollection 2017.
Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is one of the leading causes of hospitalization and is associated with considerable mortality, for which clinicians are seeking useful and easily obtained biomarkers for prognostic evaluation. This study aimed to determine the potential role of the neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) as prognostic makers for hospital mortality in patients with AECOPD.
We included 303 patients with AECOPD in this retrospective study. Clinical characteristics, NLR, PLR, and serum levels of C-reactive protein (CRP) and other data were collected. Relationships between NLR/PLR and CRP were evaluated by Pearson's correlation test. Receiver operating characteristics curve and the area under the curve (AUC) were used to assess the ability of NLR and PLR to predict hospital mortality in patients with AECOPD.
Mean levels of NLR and PLR of all patients with AECOPD were 7.92±8.79 and 207.21±148.47, respectively. NLR levels correlated with serum CRP levels (=0.281, <0.05). The overall hospital mortality rate was 12.21% (37/303). Levels of NLR and PLR were signifi-cantly higher among non-survivors compared to survivors of AECOPD (both <0.05). At a cut-off value of 6.24, the sensitivity and specificity of the NLR in predicting hospital mortality were 81.08% and 69.17%, respectively, with an AUC of 0.803. At a cut-off of 182.68, the corresponding sensitivity, specificity and AUC of PLR were 64.86%, 58.27%, and 0.639. The combination of NLR, PLR, and CRP increased the prognostic sensitivity.
NLR and PLR levels were increased in non-survivor patients with AECOPD, and the NLR may be simple and useful prognostic marker for hospital mortality in patients with AECOPD. More studies should be carried out to confirm our findings.
慢性阻塞性肺疾病急性加重(AECOPD)是住院的主要原因之一,且与相当高的死亡率相关,临床医生正在寻找有用且易于获得的生物标志物用于预后评估。本研究旨在确定中性粒细胞与淋巴细胞比值(NLR)和血小板与淋巴细胞比值(PLR)作为AECOPD患者医院死亡率预后指标的潜在作用。
我们在这项回顾性研究中纳入了303例AECOPD患者。收集临床特征、NLR、PLR以及血清C反应蛋白(CRP)水平等其他数据。通过Pearson相关性检验评估NLR/PLR与CRP之间的关系。采用受试者工作特征曲线及曲线下面积(AUC)来评估NLR和PLR预测AECOPD患者医院死亡率的能力。
所有AECOPD患者的NLR和PLR平均水平分别为7.92±8.79和207.21±148.47。NLR水平与血清CRP水平相关(=0.281,<0.05)。总体医院死亡率为12.21%(37/303)。与AECOPD幸存者相比,非幸存者的NLR和PLR水平显著更高(均<0.05)。在临界值为6.24时,NLR预测医院死亡率的敏感性和特异性分别为81.08%和69.17%,AUC为0.803。在临界值为182.68时,PLR相应的敏感性、特异性和AUC分别为64.86%、58.27%和0.639。NLR、PLR和CRP联合使用可提高预后敏感性。
AECOPD非幸存者患者的NLR和PLR水平升高,NLR可能是AECOPD患者医院死亡率的简单且有用的预后指标。应开展更多研究以证实我们的发现。